Order by Fax

585-458-6309

Order By Phone

585-458-5190

Order by Mail
L. James Feltz Upholstery
83 Finch Street 
Rochester, N.Y.  14613


Phone: _______________________  email: __________________________ fax#: __________________________

Bill To/Ship To:

Name: _________________________________________________________________________

Street: _________________________________________________________________________

City: ______________________________________________ State: _________Zip:___________

Qty.

Model Number

Model Name

Manufacturer

Fabric#

 Fabric Name Wood Finish Style

Dimensions

 Unit  Price
                     
                     
                     
                     
                     
                     
                     

Total Purchase

    $

Domestic Shipping

    $      

Sales Tax (8% New York Residents)

    $

Total Order

    $

Method of Payment

VISA___  MasterCard___  Business Check___ Personal Check___  Money Order ___

Card Number:

 

 

 

 

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Experation:

 

 

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Signature: ____________________________________________________Date: _________